Primary Ampullary Adenosquamous carcinoma: Report of two cases

Introduction: Adenosquamous carcinoma of the ampulla of Vater is a rare neoplasm with its clinicopathological profile limited to a few case reports. Here we report clinical profile, morphology and outcome of two cases of this rare entity. Case report: Case 1 was a 57 year old male who presented with features of obstructive jaundice; Case 2 was a 55 year old female with complaints of pain abdomen. Imaging studies suggested a pre-emptive diagnosis if periampullary malignancy for which both patients underwent Whipple's pancreaticoduodenectomy. Histopathological examination revealed an ampullary malignancy with variable proportions of adenocarcinoma and squamous cell carcinoma. Case 2 also showed concurrent region lymph node metastasis. Case 1was alive at 15months follow up with no recurrence/metastasis while case 2 survived for only 10 days post surgery. Conclusion: Adenosquamous carcinoma occurring at the ampulla of Vater is a rare event with less than 15 cases documented in the English literature so far. It is an aggressive tumour and is associated with a dismal prognosis. Here we add two more cases to the literature for better understanding of the clinicopathological profile, prognostic indicators and clinical outcome of this rare neoplasm.